JOHANNA SHAPIRO, LLOYD RUCKER & DANIEL ROBITSHEK
Medical educators often express concern at the tarnishing of medical students’ idealism and optimism during their clinical years (Marcus, 1999). Students themselves share these apprehensions (Lu, 1995), and research documents increased distress and cynicism (Newton et al., 2000; Hojat et al., 2002) as well as a deterioration in key communication skills (Prislin et al., 2000) and a plateauing of moral development (Branch, 2000). Although some observers report a ‘rebound effect’ in the fourth year of training, in general the rise of pessimism, disillusionment and burnout among medical students as they proceed through training is cause for concern.